November 11, 2014

The Beef With Kemper Arena

Kansas City heavy hitter Tony Botello of Tony’s Kansas City is not exactly a bashful guy. In a recent blog post on his website, he strongly criticized Show-Me for not weighing in on recent events involving the future of Kemper Arena, KC’s 1970s-era multipurpose sports facility. I’m happy to step on the scale.

For those unfamiliar with the Kemper situation, the shortest of the short stories is one of a contract dispute. The American Royal—a century-old nonprofit and scholarship-granting organization focused on agriculture—has a lease with Kansas City to use Kemper but doesn’t think the city has maintained the facility at the level the city promised.

Why the city would neglect Kemper is straightforward enough; the arena has operated in the red for years now, and with the Sprint Center now online downtown, the public face of the city for many concerts and sporting events is no longer in the Bottoms, but on the Bluff. Rather than continue to operate in what it says is a poorly maintained facility, the Royal wants the arena bulldozed and replaced with a new facility that more closely accommodates the Royal’s mission and substantively fulfills the requirements of their lease, which extends amazingly until 2045.

In light of the maintenance requirements and duration of the lease, how much does the Royal say the city is liable for?

Based on the numbers that the American Royal received and validated with the city, [American Royal attorney Chase] Simmons said, the city has $150 million worth of obligations to the organization, on top of the $2.5 million it’s losing on average each year.

In other words, this was a dumb lease by the city for an older facility, whose subsidies we have criticized before. Our longstanding objections to city-ownership of sports stadiums still stands, but it’s accentuated here by what has happened in Kansas City with Kemper Arena. The city has a money pit on its hands and, on top of that, appears to have done a poor job of honoring its remaining lease obligations.

But that doesn’t make the American Royal a victim or a hero in all of this. (Disclosure: I am a Governor with the American Royal.) When the city balked at the Royal’s plan to bulldoze the arena, another group proposed turning Kemper into a multipurpose community sports facility, leveraging . . . historic preservation tax credits. Just two years ago I criticized not only Missouri’s practice of throwing historic preservation incentives around, but I was specifically critical of throwing them at Kemper Arena. The “Foutch Plan” (as it was called) was an alternative, and as a matter of policy it wasn’t “better,” but it did have the positive effect of forcing the Royal to try to make its proposal more attractive.

When it appeared the city may accept the Foutch Plan over the Royal’s, the Royal did something really, really sad—it floated the possibility that it would move out of Kansas City entirely, a nuclear option presumably intended to shock the city back to the Royal’s side. In my view, an American Royal outside the West Bottoms is not the American Royal, and I think most civic leaders would agree with that view. In any case, such a move by the Royal would almost certainly rely on subsidies provided by someone else in the region, probably in Kansas, which would  run afoul of Show-Me’s longstanding opposition to border war incentives.

Ultimately the idea of moving didn’t tip the scale to the Royal, but litigation threatened by the organization against Foutch did, and Foutch dropped its proposal. That threat, while effective in pushing out the competing plan, exacerbated the PR nightmare that got rolling after the Royal’s leadership threatened it could move. But that’s where things stand today: The Royal’s plan appears on track to prevail, and Kemper appears on track to be bulldozed.

The most basic reaction we would offer here is that Kansas City shouldn’t have been in the arena business anyway. Moreover, the overly generous terms of the lease goes to show that trusting government to act as a fiduciary for taxpayers in financial matters is hardly ever prudent. We rejected historic preservation tax credits to save Kemper and also reject border war incentives that would subsidize the Royal so that it could possibly move out of Kansas City.

However, we support contract rights, and to the extent that an agreement was made between the Royal and the city, the terms of that agreement have to be substantively performed. Taxpayers deserved a better deal than the one the city made, but they got a lot of bull instead. And like the city’s predicament with the money-hemorrhaging Power & Light District, what taxpayers deserve does not change what taxpayers are on the hook for. Yes, the Royal may eventually “win” the question of what happens to the Kemper Arena property, but that win will have come at a price—for the organization, and for the city.

There has to be a fundamental shift in the political and policy culture of Kansas City if we are to avoid debacles like this in the future, and that means fighting bad ideas before they are implemented and educating taxpayers about better development strategies that will make them, their families, and their communities better off by empowering them, not the government.

October 29, 2014

Indebting Missouri’s Children and Expanding Government? That’s Just Wimpy

Although the Popeye the Sailor cartoons were made long before I was born, I was a connoisseur of the VHS copies I had as a kid. Along with Popeye, the shows typically featured his nemesis, Bluto, and his love interest, Olive Oyl, but perhaps the most memorable character from the series outside of Popeye himself was his companion J. Wellington Wimpy. Unfortunately, he’s memorable for all the wrong reasons.

Wimpy is soft-spoken, very intelligent, and well educated, but also cowardly, very lazy, overly parsimonious and utterly gluttonous. He is also something of a scam artist and, especially in the newspaper strip, can be notoriously underhanded at times.

In the animated cartoons, Wimpy comes off as someone who not only is unreliable in his words but, ultimately, self-aggrandizing in his behavior. His signature phrase, “I’ll gladly pay you Tuesday for a hamburger today,” hints that Wimpy will never pay you at all.

Even as a kid, Wimpy’s character was troubling because, like most children, I was well-acquainted with the idea of “fairness.” Wimpy was always willing to make others worse off for his own immediate benefit, and because of Wimpy’s generalized character issues, it was just hard to like him.

Wimpy would make you worse off . . . and he’d do it with a smile. When I think about how government and its politicians operate, that is, unfortunately, one of the images that comes to mind.

Perhaps this Wimpy image is most appropriate when it comes to the Obamacare debate in Missouri. On the one hand are the true believers who, despite evidence to the contrary, believe that government health care is the best health care. On the other hand are the Wimpys of the debate, whose support of Obamacare’s Medicaid expansion has more to do with their near-term interests than the long-term consequences of their actions. Those consequences include billions of dollars in new spending and debt saddled on future generations to fund a failing and flailing health care program, meant to explicitly benefit the well-connected and highly profitable hospital industry. So before we pick up the Obamacare expansion fight in 2015, let’s be clear: that’s just wrong.

I have no problem disagreeing with and debating folks who have a worldview that expanded government is better policy than small government. We can win that debate on the facts. But I have a serious problem with those out there who have concluded that expanded government is better politics—the contingent that’s calculated that they won’t be paying for their hamburger when the bill comes due.

That’s just Wimpy. Missouri needs genuine Medicaid reform. Fix Medicaid. Don’t expand it.

October 22, 2014

Missouri’s Medicaid Program Striking Out Intended Beneficiaries

In baseball, getting a hit three out of 10 at-bats could make you an All-Star, and maybe even a Hall of Famer if you do it consistently enough. But while batting .300 is pretty good for the National Pastime, in most other contexts succeeding only three out of 10 times won’t get you accolades.

That point was hit out of the ballpark over the past few days.

Last week mid-Missouri’s ABC 17 reported on the story of a pregnant woman who had been trying to sign up for Medicaid benefits, only to have her paperwork lost and her calls unreturned by the Department of Social Services (DSS). When the issue came up at a House hearing, the DSS admitted it had to do better, but it also admitted something astonishing (emphasis mine).

The Department says thirty percent of its callers are having their needs met, which Campbell acknowledges is too low. She says staff are being reassigned to taking calls and other changes are being made to improve that percentage, but [State Rep. Sue] Allen says the situation remains frustrating.

“In a company, in a private business, people would be gone,” observes Allen.

Missouri’s Medicaid program is deeply broken, and yet some of our politicians think now is the time to expand it with Obamacare. It isn’t. In baseball and business, step one would be to fix what is wrong and then build upon successes, not to double-down on a bad system and bad players. That’s what Missouri should be doing: fixing Medicaid, not making an already bad situation worse—especially for the patients the program was supposed to help.

Missouri’s Medicaid system is institutionally well below the Mendoza line. It’s time to rethink the program.

October 15, 2014

Increasing the Health Care Supply to Meet Health Care Demand

Robert Graboyes is a senior research fellow for the Mercatus Center. Later this month Dr. Graboyes will release a report about health care innovation, which I intend to talk about at some length on this blog. In the meantime, I want to re-up the Reason video from earlier this year. The video features Dr. Graboyes talking about a wide array of reforms that would get care to the neediest among us. If you’ve read our work before, you’ve probably heard of many of the recommendations he talks about, including regulatory, Medicaid, certificate of need, and scope of practice reforms. I highly recommend the video, particularly the section about prosthetics and 3-D printing, which captures well how quickly the market for health care could change in the coming years.

October 14, 2014

Free-Market Health Practitioners Get a Group

Late last month, supporters of the newly established Free Market Medical Association (FMMA) converged on Oklahoma City for the organization’s first ever annual conference. As the name suggests, the organization is intended to bring doctors and providers together to share ideas and defend “the practice of free market medicine without the intervention of government or other third parties.” Given the sorts of reforms American health care needs these days, the FMMA’s entry onto the national stage is a welcome one.

Along with noting the FMMA’s existence, there’s also a reason worth teasing out for why the FMMA held its first conference in Oklahoma City. The short answer is “it’s where the FMMA’s organizers are based,” but a more complete answer is it’s where some very interesting free-market business models are being put into practice.

Advocacy of free market health care is the longtime passion of Dr. Keith Smith, co-founder of the Surgery Center of Oklahoma [and the FMMA]. The center began to post fixed prices for common medical procedures years ago, and has provoked widespread admiration within the medical profession for efficiency, reasonable cost and frequent support for those who are less fortunate.

At the Surgery Center, Dr. Keith Smith and Dr. Steve Lantier have established an operational structure and market-oriented billing as explicit alternatives to the third-party payer systems that now dominate U.S. health care.

The center posts online an up-front price for medical procedures in diverse areas of practice, including orthopedics, ear/nose/throat, general surgery, urology, ophthalmology, foot and ankle, and reconstructive plastics. In all, a total of 112 procedures are listed.

Translation? Transparent pricing plus direct pay works out to a pretty good business model premised on competition and service. Price transparency is huge because it’s generally pretty difficult to price shop in the U.S. health market, in part because the third-party payer system disincentivizes it, and because many providers aren’t willing to publish those prices. That makes it difficult to force prices down through competition. Posting prices should be common practice in the industry; unfortunately, it’s not.

It’s good to see folks in the movement getting organized when it comes to demonstrating that, yes, free-market reforms to health care do exist and can work. In the coming months, Show-Me readers will hear a lot more about free-market health care alternatives. Stay tuned.

September 9, 2014

Ditch the Tax Incentives and Pursue General Tax Cuts Next Year

The Missouri Legislature’s 2014 veto session begins this week, and the chambers are set to reconsider dozens of bills rejected by the governor earlier this summer. While a handful appear to have enough support for an override, most sit in legislative limbo, fates to be determined. Among those bills hanging in the balance are a package of tax incentives I’ve talked about many times before.

These incentives are bad policy in general, but to create these handouts well outside of the legislature’s normal budgeting protocol is inexcusable. The budget must balance, and this late-breaking special interest goody bag throws the state’s budget out the window. Missourians deserve better than to be treated like a cash spigot for the well-connected.

There’s also a larger picture that needs to be understood here. Some of the most vocal tax cutters are also big boosters of tax incentives, but by creating, expanding, and sustaining tax handouts like these, our state is making the enactment of future tax cuts much more difficult. We should all be paying for the cost of our government, but increasingly, well-connected special interests are being exempted from that burden. That’s wrongheaded policy. As a general rule, if taxes are going to fall for anyone, they should fall for everyone. It’s time to kick the tax incentive circus out of Jefferson City.

The legislature should come back next year and pass broad and responsible tax cuts for Missourians. The first step is rejecting this year’s incentives.

July 14, 2014

‘Right To Try’ Law Gets Gov. Nixon’s Signature

Today is the last day for Missouri Gov. Jay Nixon to veto or sign legislation that the 2014 General Assembly passed. So, with the state’s “Right to Try” proposal still sitting on his desk, I started my workday with a smidgen of trepidation. “Right to Try,” you might remember, would empower patients with terminal illnesses to more freely seek experimental medications in hopes of finding something that could help them.

The concern: Would the governor veto “Right to Try” this year, much like he vetoed the Volunteer Health Services Act last year?

The answer: Nope. He just signed it.

The Governor signed two health-related bills, which will provide Missourians in specific situations with additional options for medical treatment of illness and disease. House Bill 1685 allows drug manufacturers to make available investigational drugs, biological products, or devices to certain eligible terminally ill patients. House Bill 2238 allows the use of hemp extract to treat some individuals with epilepsy and also allows the Department of Agriculture to issue licenses to grow industrial hemp strictly for research purposes. House Bill 2238 contains an emergency clause.

I talked about this bill a lot in the last few months. This was, to me, an obvious opportunity to empower people to make each other’s lives better. The government should open doors for people to care for one another, not erect and maintain barriers to helping each other. “Right to Try’s” enactment is not only a victory of reform-minded policy, but more importantly, it is a victory for Missourians in need.

Congratulations to the Missouri House and Senate for sending the bill to the governor, to the legislators who sponsored the bill and powered this important conversation, and to the governor for making the right decision by adding his support to the unanimous votes of the legislature. Well done.

June 18, 2014

Thank Obamacare: Buchanan County, Mo., Tops List For Insurance Rate Hikes On Men

Last year, Forbes published a story about how much insurance rates were expected to rise across the country because of Obamacare. Today, Avik Roy and his crew published their follow-up. The study has bad news for just about everybody, but our own Buchanan County appears to have been hit especially hard by the President’s signature legislation. (Emphasis mine.)

Our new county-by-county analysis was led by Yegeniy Feyman, who compiled the county-based data for 27-year-olds, 40-year-olds, and 64-year-olds, segregated by gender. We were able to obtain data for 3,137 of the United States’ 3,144 counties….

Among men, the county with the greatest increase in insurance prices from 2013 to 2014 was Buchanan County, Missouri, about 45 miles north of Kansas City: 271 percent. Among women, the “winner” was Goodhue County, Minnesota, about an hour southwest of Minneapolis: 200 percent. Overall, the counties of Nevada, North Carolina, Minnesota, and Arkansas haven experienced the largest rate hikes under the law.

Amazingly, that 271 percent figure conceals something else about Buchanan that is just jaw-dropping. If you use Forbes’ national rate navigator, you discover that a 27-year-old man in Buchanan County can expect an individual insurance policy rate increase of — get this — 411 percent.

This is “affordable”? How can any politician tell his or her constituents with a straight face that Obamacare is working, or that we need to help the Feds implement this disaster in Missouri? Missouri needs market-based insurance reforms, not Obamacare and its Medicaid expansion. Our people deserve better than this raw deal.

June 5, 2014

Governor Should Veto Data Center Tax Exemption Legislation

The legislative session may be over but that doesn’t mean the lawmaking is done. Missouri Gov. Jay Nixon has a plethora of bills before him at this writing that he can either veto, sign, or let pass into law without his signature. Among them is a battery of sales tax exemption changes that deserve the additional scrutiny the governor is giving them.

When the legislative session started, talk about sales tax exemption changes generally focused on a problem the legislature actually needed to address — whether personal training services should constitute “entertainment” for sales tax purposes. Unfortunately, that evolved into a package of legislation (encompassing several bills) that also included sales tax exemptions for manufactured homes, data centers, electricity transmission, and more. The governor is predicting that the cost to the state for the bills could be upwards of $400 million, with hundreds of millions more in costs at the local level.

Whether that top-line total is exactly correct, it is clear that many of these sales tax carve-outs look a great deal like special interest income tax credits when it comes to the narrowness of the benefits and the political considerations that went into extending them. Indeed, legislators have been trying to direct tax credits to data centers in the state for years now. That the legislature decided to throw money at the industry through a different section of the tax laws comes, unfortunately, as little surprise.

The legislature is right to cut taxes for Missourians, but cutting big special deals for favored industries, whether through tax credits or exemptions, should be a non-starter. More to the point, the governor should veto the data center legislation even though doing so would mean better tax policies — which were bound to the fate of the questionable exemptions — will have to be reintroduced next session. If he does, next year, the legislature should take what the state would have foregone with the business exemptions and apply much of it instead to broad tax cuts for businesses. If the state can do without the millions in revenue assigned to many of these special exemptions, it can continue to do without that revenue — but this time through broad tax cuts. That would be a better policy.

June 4, 2014

Sweetness And Power & Light

I want to follow up briefly on the pieces recently published in The American Spectator and here on the blog about entertainment district subsidies in the Show-Me State. Michael Rathbone’s review of Saint Louis’ Ballpark Village is worth your time if you haven’t read it yet. But I want to highlight again Kansas City’s own tax incentive sinkhole, the Power & Light District. The Wall Street Journal video below is an oldie but goodie that captures how expensive the city’s entertainment district gamble has been — and how expensive it will continue to be in the years ahead.

The cost of the city’s plan has actually gotten worse since the Journal published this video in 2012. Just a few months ago, the Kansas City Council actually voted to refinance the district’s debt to help pay for pensions, extending the term of the repayment period and adding tens of millions of dollars to the district’s cost.

The refinancing calls for adding seven years to the Power & Light entertainment district’s debt payments, from 2033 to 2040. It lowers the payments from 2015 through 2019 and frees up cash to help pay for pension reform, especially in the 2014-15 budget. But it bumps up the debt payments between 2020 and 2040, a net increase in overall debt of $36 million.

Who’s going to pay for all of these costs? Kansas Citians, of course, most likely through higher taxes, lower services, or a combination of the two. Businesses that have to compete with the newly subsidized competitors will also be paying for it not only in tax dollars but in customers, too, as their clientele are diverted to new taxpayer-funded developments. If these massive projects were going to work, they should be able to make it on their own, and as the Spectator observed:

The forbidding economics of these projects should be evident from the start, since their need for subsidies shows that they have inadequate market demand. Yet they continue to open, representing the fallout that occurs when officials speculate with public money.

That chronic speculatory impulse of Missouri’s public officials must stop. If our local and state governments can afford to massively cut taxes for some, they can afford to cut taxes for all. That’s the direction in which tax policy in this state must continue to move.

May 16, 2014

Landmark ‘Right to Try’ Legislation Crosses The Finish Line

As the session was coming to a close this afternoon, the Missouri House and Senate both passed the “Right to Try” bill and sent the legislation to the governor. As I’ve written and testified in the past, the law will allow greater flexibility for terminally ill patients. Specifically, it allows these patients to seek medications that the drug companies have developed and the FDA has determined to be safe for humans, but are not yet sold on the market. Assuming the governor does not block it, Missouri is set to become one of the first states in the country to enact such legislation. Following the passage of last year’s Volunteer Health Services Act, Missouri is certainly on a roll when it comes to enacting forward-looking and people-empowering health care reforms. Right to Try’s passage is a victory for Missourians.

Congratulations to the legislators who made the bill happen, to the Goldwater Institute, which has pioneered the idea, and most importantly, to the patients and families who will benefit from this law’s enactment.

Medicaid Expansion Push Fails Again; Ditch The Spending And Enact Real Reform

This Wednesday, the Obamacare crowd introduced, and then withdrew, their final attempt at Medicaid expansion in Missouri. That means the state will not expand Obamacare for another year, and that’s good news for Missourians. It isn’t “conservative” to strap a spending bomb to substantive Medicaid reforms and then call the whole thing a “transformation.” Legislators were right to reject it.

Instead of suggesting that special interests will block substantive Medicaid reform, Missouri’s policymakers should stand up, fight the special interests rather than carry their legislation, and deliver the Medicaid fixes we have been promised for years. That some lawmakers would articulate specific reforms and yet would block their progress as a way to force an expansion is as cynical as it is disappointing.

No doubt, expansion supporters will promise that the Medicaid fight will continue next year. And they’re correct. We’ll see you then.

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